Karou

I've got a few pet peeves I recently identified by forgot all except this one right now- Patients who act as if they are the only patient. Even if across the hallway someone is dying, and they know it. This exact situation has happened more than once recently. I realize when we are ill it's normal to be somewhat self centered but am shocked at the callousness of some people.

In some ways it has. I am not so naive to people and their intentions. It's hardened me in that way. I am frustrated by watching people destroy themselves and feeling like my role as a nurse is not helpful in meaningful long term change for most of those people. I realized I can't like everyone, not even some of my patients. In general I have become much less trusting of any people, more suspicious. I've developed a dark and sarcastic sense of humor. I complain a LOT about work. Balancing that, I've never felt so accomplished and productive. I love many of my patients. Being a nurse and making any kind of small positive impact gives me a massive sense of satisfaction. I like my job- prioritizing, organizing, multitasking, critical thinking, learning something new constantly, ect... I also enjoy the social aspect and forming bonds with my coworkers. Outside of work I am extremely satisfied with my life. I own a home, am close with my family, have a wonderful husband am starting a family. This is where I always wanted to be.

When I was hospitalized years ago, I received morphine (no idea on dosage) and instantly threw up everywhere and it did nothing for the pain, but it made me very foggy and confused. Then they gave me a small dose of dilaudid, followed by phenerghan for the nausea. First time for any IV narcotic, first time being hospitalized, weighed about 105lbs. That combo put me in another realm. Instant relief, happiness, peace. I smiled blissfully through several painful tests then slept on/off for three days, during which I had the most painful headache of my life (doctors guessed that was from the morphine). Dilaudid was bliss but I want to avoid it in the future. It was TOO good.

Did anyone ask the physician about the Imodium? Was it something the doctor intentionally ordered, or was it part of a standard order set and perhaps overlooked? If I had a patient admitted with constipation who then developed diarrhea (still taking narcotics, right?) I would be extremely hesitant to give an anti diarrheal agent even if specifically approved by the physician. This patient is still at risk for constipation. Narcotics, nearly resolved constipation, probably less mobile than at home... Despite current diarrhea the pt is still at risk I would explain my rational for not administering it to the patient, discuss with the physician as appropriate, and encourage increased fluid intake to prevent dehydration.

No, that's asinine. 1. I would never risk my job for that. What fool would? 2. I abstain from any mind/mood altering recreational drugs (including alcohol, which is far more dangerous in my opinion than weed). It's a very personal choice that I have made and am very firm on.

I would find a new job. There should be a CNA to help with so many of these tasks. You can't turn and clean a total care patient yourself... You shouldn't! This requires 2 people. It's ridiculous that nurses are now expected to do real at housekeeping duties. A big pet peeve of mine. The discharge navigator can't leave at 3, that's absurd! Most discharges occur afternoon in the hospital setting. What a useless position if they don't stay at least until 5pm. They are legally obligated to pay you for a lunch break not taken. It's not this bad everywhere else. Look around and ask nurse friends about their places of employment.

Blackout blinds + blackout curtains make your bedroom a dark den of delicious night. Blackout blinds are expensive but worth it! Eye mask, earplugs, fans for white noise as appropriate. Shower before bed to relax you (unless that makes you energetic, whatever works for you!). Some say eat or don't eat... I can't go to bed on an empty stomach so I have a small bowl of cereal or something similar. Phone on vibrate or silent. Make family members aware of your schedule. Eat before you go to work- high protein is best. Bring multiple healthy snacks to munch on. Drink plenty of water at work. I wear sun glasses on my way home to keep me night like and sleepy. I take melatonin sometimes on occasion for sleep. I love it. I'll post more tips if I can think of any.

Oh yes! They come to the unit and we hear about it non stop, even once they've gotten their dilaudid here. I'm not sure if the change will last or if it's made any difference down in the ER. For the rare patient there truly allergic to morphine and needs the dilaudid, I feel sorry for them.

What's interesting to me is that if this had been a male nurse taking pictures of his female patients genitals, he would probably have to register as a sex offender. There is more than a HIPAA or ethical violation here! She got probation and surrendered her nursing license. A slap on the wrist.

Interesting. Our ER stopped stocking dilaudid as a way to be less appealing to drug seekers. Not sure how effective that has been. They will still do morphine and other drugs but dilaudid has to be sent from pharmacy (which it never is on time).

There are a few different ways to get into teaching. Since you already have a college degree (BSN or ASN) it's not as difficult as starting from scratch. Start looking into your local colleges (maybe even online ones) and do some research into what it takes to get hired into the school districts around you. I have two teacher friends, both went the short route. One had a bachelors degree in French, ended up teaching that in a low income/poverty district that forgave her loans. The other was an LVN who disliked nursing, worked as a school nurse for a while, then went back to school for teaching. Do what makes you happy!

I haven't read your other posts OP, I don't really care to. I am pretty full of your entitled attitude from this one alone. The part that tipped me over was your bragging about your husband and speculating that your supervisor is jealous of you, when there are clearly valid reasons as to why you are getting in trouble. This shows me that you don't take your job and responsibilities seriously. You would rather assume someone is jealous/targeting you then own up to your part in all of this. They probably want an employee who doesn't inconvenience them as much with frequent doctors appointments and tardies. I also wonder if this entitled attitude spills over at work and sours others impressions of you. You take very little accountability for yourself and are full of excuses. Since your husband makes such high income and you've said you aren't working for the money, you should have no problem being a stay at home mom and paying off your student loans. Good luck.

A seriously good question (for your DON) is how long would all those other "in house" interventions have taken? Call for x-ray, waiting for x-ray to actually come, get stat antibiotics delivered from a pharmacy, insert IV and administer those antibiotics... X-ray report read??? That could all take a considerable amount of time, meanwhile your patient is short of breath and miserable. As soon as it progresses to respiratory distress, the hospital is choice. What were the oxygen sats? I don't think the hospital is keeping the patient for revenue. Honestly, in my experience, patients are being discharged earlier and earlier so that more patients can accommodate their beds.

Am I the only one getting the vibe that the OP possibly has a family member with PD who was given Haldol? This seems personal. Safety is priority #1. When a patient is delirious and becoming a danger to themselves or others, something must be done, and done quickly to prevent harm. Haldol would not be preferred, but possibly necessary if alternatives have been tried without success.

Ugh, I have worked with people like that. If it's a bed alarm I will always respond no matter who the patient belongs to. Beeping IV's are like nails on a chalkboard so if I hear one, I'll hunt it down. I say something in these situations. You have to or it won't ever improve. I'll say hey I've been getting your call lights, bed alarms, and IV's, but I really need to chart now. Can you stay on the hall and keep an ear or for your patients? It would be great if you could help me out too. To be more blunt, I've told a hallway partner that they are leaving too much and I am having to care for their patients, that they need to stay on the hall. No one likes working with these people, but instead of running ragged you need to say something.